Understanding and stabilising hypovolaemic shock in patients with gastric dilatation and volvulus

Gastric dilatation and volvulus (GDV) is a surgical emergency that is commonly seen in larger-breed dogs. In GDV, the stomach twists and swells to a significant degree, causing compression of the caudal vena cava, which can very quickly lead to hypovolaemic shock and death if left untreated. Veterinary nurses play a central role in the rapid assessment, stabilisation and ongoing care of patients with GDV. Affected dogs commonly present with retching, hypersalivation, restlessness and marked abdominal distension, but they may also exhibit complex haemodynamic and metabolic disturbances requiring immediate intervention. This article reviews the physiological responses to fluid loss, highlighting how compensatory mechanisms can initially mask hypotension and delay recognition of hypovolaemic shock. It explains the progression from acute neural responses to hormonal mechanisms and the consequences of inadequate perfusion, including the development of metabolic acidosis and rising blood serum lactate. The article outlines the clinical relevance of lactate measurement in assessing perfusion status and monitoring the response to fluid therapy. Intravenous fluid therapy is discussed in detail, including the rationale for using hypertonic saline for rapid intravascular volume expansion, followed by isotonic crystalloids to restore interstitial and intracellular hydration. Guidance is provided on appropriate catheter placement in dogs with GDV, with emphasis on avoiding hindlimb veins due to impaired venous return. The article also summarises key signs of fluid overload to support safe and effective nursing care. Overall, the aim is to equip veterinary nurses with the knowledge and confidence to manage these critically ill patients.